Provider Demographics
NPI:1124368881
Name:ADULTS AND CHILDREN INTERVENTION SERVICES LLC
Entity type:Organization
Organization Name:ADULTS AND CHILDREN INTERVENTION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS-EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-488-1468
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10802-0042
Mailing Address - Country:US
Mailing Address - Phone:954-488-1468
Mailing Address - Fax:
Practice Address - Street 1:39 DAVENPORT AVE APT 1F
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-3409
Practice Address - Country:US
Practice Address - Phone:954-488-1468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-18
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11883251C00000X, 252Y00000X
252Y00000X, 261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No252Y00000XAgenciesEarly Intervention Provider Agency